What do we need to learn in CRAS?
Understanding of CRAS is steadily growing, but there are outstanding key questions that need answers.
From the inaugural CRAS Academy meeting in Zurich, Switzerland in February 2010, a number of key issues were highlighted by the internationally renowned faculty.
- What is the true prevalence of CRAS? There is a lack of data from large trials to determine how many CRS patients suffer from iron deficiency and/or anaemia
- How can management of patients with CRAS be optimised? Patients are either seen by a cardiologist or a nephrologist first, and this can influence management. What sort of multidisciplinary care model is required to help patients with CRAS be treated holistically?
- Will optimising the treatment of iron deficiency anaemia have any beneficial effects on the symptoms of CHF or CKD? Intravenous iron may improve the symptoms of CHF in some patients1, although it remains to be seen if this represents an effect on the underlying disease.
- Will optimising the treatment of iron deficiency and/or anaemia reduce mortality rates among patients with CRAS? Properly designed and powered trials addressing the effect of anaemia management on CHF and CKD symptoms and pathology are urgently needed, such as the RED-HF (Reduction of Events With Darbepoetin Alfa in Heart Failure; http://clinicaltrials.gov/ct2/show/NCT00358215) trial.
CRAS-Academy.com will be updated regularly with the latest information on scientific and clinical research addressing these questions.
1. Anker SD et al. N Engl J Med 2009;361:2436–2448